Open enrollment period still open, but not for long

Tuesday , December 05, 2017 - 5:00 AM

CATHY MCKITRICK, Standard-Examiner Staff

This year’s abbreviated open-enrollment period for individual health insurance coverage — Nov. 1 to Dec. 15 — has started winding down. But there is still time to explore plans and sign up for an option that might help 2018 run more smoothly.

Utah residents now have only two insurers from which to choose on the health insurance marketplace: SelectHealth (a division of Intermountain Healthcare) and the University of Utah Health Plans.

Patricia Richards, president and CEO of SelectHealth, underscored the importance of people either keeping or getting coverage.

“People with health insurance have better access to preventive care, get better care with chronic conditions — and even if you’re healthy, unexpected things happen that can be devastating both personally and financially,” Richards said. “Coverage gives peace of mind.”

Jamee Wright, spokeswoman for SelectHealth, said their call volumes continue to trend at about 500 per day.

“These calls are coming from current members as well as those who have questions and are shopping to understand their options,” Wright said.

After Molina Healthcare announced its exit from the marketplace in August, U of U Health Plans expanded to provide coverage in all of Utah’s 29 counties. According to its website, U of U Health Plans offers access to over 36 hospitals, 8,700-plus providers and 56 urgent care clinics throughout the state.

Chad Westover, CEO for U of U Health Plans, said that expansion has brought new enrollees from all across Utah.

“I hope that people will really study to find a plan that will work for them,” Westover said, noting that Molina had insured roughly 70,000 people in Utah. “Their provider network was very similar to the one we have. So if they want to keep their current providers, virtually all of them would need to select U of U Health Plans.”

While Republicans in the U.S. Congress had hoped to dismantle the Affordable Care Act (aka Obamacare) by now, it continues to function as the law of the land. But its individual mandate, which helped to spread the burden of health care costs over a larger group, will likely disappear pending final reconciliation of the GOP’s House and Senate tax reform bills.

“We anticipated there would be weakening of the mandate. Trump had indicated he would do that. So we put some of that impact into our pricing,” Westover said. “I don’t know if people are purchasing insurance because they understand they are one accident or one diagnosis away from needing the assurance that it affords, or if they’re doing it because of the mandate. But I would recommend they look at the long-term because insurance is about protecting yourself from unknown risks.”

Health insurance premiums are rising amid so much uncertainty over what might remain intact in the Affordable Care Act, and Richards cited factors contributing to those increases.

“Getting rid of the individual mandate is like saying, ‘Well, you don’t really have to have insurance, but if something happens, you can get it.’ That doesn’t really work in the long-term,” Richards said.

In October, President Donald Trump announced the elimination of Obamacare cost-sharing reductions (CSRs) which offset deductibles and other out-of-pocket expenses for roughly 7 million Americans who earned up to 250 percent of the federal poverty level.

Richards also pointed to rising prescription prices as a key culprit in skyrocketing health care costs. According to the Alliance of Community Health Plans, both brand name and generic drug manufacturers employ extreme pricing tactics that help push health care out of reach for many Americans.

But SelectHealth has an internal prescription-benefit management company that gives them more leeway to negotiate drug prices, Richards said.

Randal Serr, director of Take Care Utah, a group of nonprofits organized to help people find individual health care plans that meet their needs, said that activity in his office has been brisk since the start of the open enrollment period.

“It’s an understatement that we’ve been very busy — busier than we’ve ever been in the last four years of doing this,” Serr said.

And Serr believes all the federal-level talk of repealing and replacing Obamacare is boosting that traffic.

“Threatening to take something away is a great way to get people to respond,” Serr said. “Obamacare is still here and available, and we walk people through options based on their income and household size.”

Molina policyholders also get an extra 60-day grace period from Jan. 1 to March 1, 2018, to select a new plan, but delaying enrollment until then could also mean risking a month or two without coverage.